HIEs are Failing

My guest column posted today at NHINWatch describes the evidence — now compelling — that our efforts to build a nationwide system of health information exchanges (HIEs) are failing. Health record banks are a feasible alternative, as explained in detail in the recent Architecture and Business Model white papers from the Health Record Banking Alliance. Are we ready to try a new approach that can succeed?

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I just happen to be on the verge of completing an MPH Informatics course (with Walden University) and only came to the blog because it was a resource given in this week’s course readings.
For someone who had no previous knowledge of informatics –other than being a user of various systems at work-I have become pretty intrigued and hooked for one reason only: I am community health worker who sees the absolute need and benefit of a Health Record Bank and-in answer to your question-the political constituency may not be necessary if the CONSUMER who is the critical piece and, ultimately the payer – can be educated enough about this to come on board.
Dr. Yasnoff’s lecture that I just ‘watched’ may be a little outdated (our school needs to update its course material) but still quite valid in terms of the way this CHII/ HRB (vs. the exchanges) revolves around the consumer. The consumer is given control -and the providers are paid to “deposit” encounters into the bank.
Case in point: I had a client who on Monday had to have an emergency dental visit. She has multiple health problems including HIV, STI, lupus, and has had multiple surgeries’ including double hip replacement.
Her pharmacist had declined to refill her prescriptions because she hadn’t seen her PC in 3 months-her PC had not received any recent blood/work notes from her Infectious disease doctor-her infectious disease doctor had not received her blood work for the lab; ultimately the dentist could not perform the surgical extraction that was needed until he was in possessions of updated medical history. Because she was in so much pain the dentist prescribed pain and antibiotic medications without any idea that she was about to get another “laundry list’ of refills that included other pain medications. Thankfully, the pharmacist emphasized she could not take all the pain medications together. He also has to scratch of one of the medications because I (the community health worker) dutifully informed him that I was aware that she had developed resistant to that particular medication
In the midst of all of this a case manger needed a confidentiality release form the patient to be able to send all this information to all these providers. The patient gladly gave it. It has taken me two days to get that done. And not without being on the phone for at least 2 hours at a time.
In the confusion and pain that this patient was in-the HEALTH BANK would have been the most helpful solution and something she would have gladly paid for to get the help she needed.
Forget political constituencies-start education the consumer.